Autoimmune Hepatitis With Inflammatory Bowel Disease Is Distinct and May Be More Refractory to Traditional Treatment

Bailey, James R.; Sreepati, Gouri; Love, Joshua; Fischer, Monika; Vuppalanchi, Raj; Ghabril, Marwan; Gawrieh, Samer; Orman, Eric S.; Chalasani, Naga; Lammert, Craig

doi:10.14309/00000434-201410002-00504

Cited by 7 publications

(6 citation statements)

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“…Nevertheless, the two recorded cases with autoimmune hepatitis were diagnosed in patients also having primary sclerosing cholangitis. Both cases of AIH were recorded in male patients, even though this autoimmune disease is predominantly found in females [33,34]. Furthermore, even though PSC is known to be associated mostly with ulcerative colitis (the 80% of all IBD-PSC cases present in UC), in our cohort we observed no difference between the two diseases [35].…”

Section: Extraintestinal Manifestations Affecting Different Organ Sys...contrasting

confidence: 60%

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Fedor

Zöld

Barta

2021

JCM

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Objectives: Thus far, few attempted to characterize the temporal onset of extraintestinal manifestations (EIM) in inflammatory bowel diseases (IBD). We sought to determine the time of onset of these findings in a patient cohort with IBD. Methods: We reviewed the electronic health records of 508 IBD patients (303 CD, 205 UC) and summarized general patient characteristics and the temporal relationship and order of presentation of extraintestinal manifestations. Results: CD patients were younger at diagnosis. CD patients with ileocolonic involvement (L3) were younger, and UC patients with pancolitis (E3) were slightly younger at diagnosis. A total of 127 out of 303 (41.91%) CD and 81 out of 205 (39.51%) UC patients had EIMs (p = 0.5898). Some patients presented with EIMs before the diagnosis of IBD (9.45% of Crohn’s disease and 17.28% of ulcerative colitis patients with EIMs, respectively). Of these, seven cases (four in CD and three in UC) were visible by inspection of the patients (either dermatologic or ocular findings). The diagnosis of IBD and extraintestinal symptoms often occurred within a year (22.83% of CD and 16.04% of UC patients). Typically, the diagnosis of the first extraintestinal symptoms happened after the onset of bowel disease (+4.3 (±6.3) years, range: 10 years before to 30 years after in Crohn’s disease and +3.8 (±10) years, range: 24 years before to 30 years after) in ulcerative colitis. UC patients with pancolitis (E3) usually had EIMs earlier in the disease course and displayed EIMs more frequently before IBD diagnosis. Furthermore, patients with pancolitis developed EIMs more frequently than other sub-groups. Conclusion: Extraintestinal manifestations in inflammatory bowel diseases can present at any time, relative to the bowel symptoms. In cases, the presence of a characteristic EIM might be a harbinger of the development of IBD.

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Section: Extraintestinal Manifestations Affecting Different Organ Sys...contrasting

confidence: 60%

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Fedor

Zöld

Barta

2021

JCM

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“…Furthermore, patients with UC have increased complications, lower remission rate of other autoimmune diseases 36 37 , increased recurrence rate of other autoimmune diseases 38 , and higher incidental colorectal cancer rate 39 than those without. These findings support the need for further study of DM in patients with UC, its relationship, and its impact.…”

Section: Discussionmentioning

confidence: 99%

Increased Cumulative Incidence of Dermatomyositis in Ulcerative Colitis: a Nationwide Cohort Study

Tseng

Chang

Liao

et al. 2016

Sci Rep

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On a molecular level, two autoimmune diseases: ulcerative colitis (UC) and dermatomyositis share common genetic determinants. On a clinical level, case reports evidenced the co-occurrence of these two diseases. We therefore hypothesize that UC is potentially associated with increased cumulative incidence of dermatomyositis. The goals of this retrospective cohort study were to evaluate whether UC is associated with increased cumulative incidence of dermatomyositis independent of sex and age. For comparison, we also assessed the cumulative incidence of polymyositis in UC and control subjects. The study enrolled 3,133 UC subjects and 14,726 control subjects. The cumulative incidence of dermatomyositis was significantly higher in UC than that of control subjects (p = 0.026), but the cumulative incidence of polymyositis was comparable between UC and control subjects (p = 0.596). UC was independently associated with the increased incident dermatomyositis (hazard ratio: 6.19, 95% confidence interval = 1.77–21.59, p = 0.004) after adjusting for sex, age, and concomitant rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. Similar trends of increased dermatomyositis in UC were observed when patients were stratified based on sex and age. In conclusion, our findings suggest that UC is probably associated with increased cumulative incidence of dermatomyositis, independent of sex, age, and concomitant autoimmune diseases.

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“…In the most significant study, out of 105 patients with AIH, only 17 had findings suggestive of UC. Clinically, patients with AIH and IBD, mostly UC, developed AIH at younger age, had a lower remission rate, a higher rate of treatment failure, and progressed more to cirrhosis[ 40 , 41 ].…”

Section: Autoimmune Diseases Associated With Ibdmentioning

confidence: 99%

“…Granulomatous hepatitis is also an infrequent manifestation in patients with IBD, being mainly described in CD. A prevalence of less than 1% has been reported and is characterized by the presence of non-calcified hepatic granulomas demonstrated in the histological study (liver biopsy)[ 41 ]. The clinical manifestations and probable etiologies are summarized in Figure 3 [ 143 , 144 ].…”

Section: Other Hepato-biliary Manifestationsmentioning

confidence: 99%

Hepatobiliar manifestations in inflammatory bowel disease: A practical approach

Núñez¹,

Castro²,

Mezzano³

et al. 2022

WJH

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Inflammatory bowel diseases (IBD) are associated with various hepatobiliary disorders. They can occur at any moment in the course of the disease or associated with the treatment. The prevalence of liver dysfunction can reach up to 50% in different studies. Nonalcoholic fatty liver disease is considered the most common hepatobiliary complication in IBD, while primary sclerosing cholangitis is the most specific. Management of hepatic manifestations in IBD involves a multidisciplinary approach that includes a high index of suspicion and joint management with hepatologists. The medical confrontation with abnormal liver tests must include an exhaustive study to determine if these patterns can be related to IBD, associated diseases or to the therapies used.

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Autoimmune Hepatitis With Inflammatory Bowel Disease Is Distinct and May Be More Refractory to Traditional Treatment

Cited by 7 publications

References 0 publications

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Increased Cumulative Incidence of Dermatomyositis in Ulcerative Colitis: a Nationwide Cohort Study

Hepatobiliar manifestations in inflammatory bowel disease: A practical approach

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